2015-05-13T13:30:00-05:00 2014-06-30 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 606064301 990 2013-07-01 431470362 Alexian Brothers Lansdowne Village ALEX 3143516888 4624 Lansdowne St Louis MO 63116 Gary Mohn Secretary 3143516888 2015-05-12 1 Laura Gillespie P00855604 3124861000 2015-05-06 2013 2016-03-07 17:11:31Z Gary Mohn 4624 Lansdowne St Louis MO 63116 11280084 0 0928 X www.alexianbrothershealth.org X 1987 MO Skilled nursing facility 7 4 227 25 0 0 5966 25637 11358322 10680438 580738 554720 22044 19289 11967070 11280084 0 0 0 0 4811195 4582525 0 0 0 6712369 6826952 11523564 11409477 443506 -129393 19013571 19624249 875200 690129 18138371 18934120 X Alexian Brothers Lansdowne Village ("ABLV") carries out the healing mission of the Catholic Church as an Alexian Brothers ministry by identifying and developing effective responses to the health and housing needs of those we are called to serve. 0 0 10288172 10680438 Skilled Nursing Facility - Inspired by the healing mission of the Alexian Brothers to the elderly, ABLV provides a continuum of care to residents that maximizes dignity and independence. Rooted in the Catholic tradition of caring, the staff is committed to promoting the well-being of those we serve through the delivery of quality care. The facility has 145 beds with an average capacity of 130.8 in 2014, 22,486 days of care were provided to Medicaid recipients, 6,255 days of care were provided to Medicare recipients. Although reimbursement for services rendered is critical to the operation and stability for the continuum of services, as a charitable organization, it is recognized that not all persons served possess the ability to purchase essential services needed for care and our mission is to serve the community with respect to providing health care services. In 2014, over $123,000 was provided in charitable care at costs. ABLV also serves the neighboring communities by providing programs throughout the year. Meeting rooms are provided at no costs to local charitable organizations and community groups. As a religious organization, ABLV also employs staff to provide chaplaincy services. The cost of community services provided in 2014 was $2,954. 10288172 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 34 0 1 227 1 0 0 0 0 0 0 0 0 0 0 0 X 7 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Joe Girardi 3147293500 12250 Weber Hill Road Suite 200 St Louis MO 63127 Pierre Smith Ex-Officio Member & President/CEO 50.00 0.00 X X 0 130350 15855 Alec Blanc Director & Chairperson 1.00 1.00 X X 0 0 0 Barbara Prosser Director & Vice Chairperson 1.00 1.00 X X 0 0 0 Charles Gulas Director & Treasurer 1.00 1.00 X X 0 0 0 Gary Mohn start 114 Director & Secretary 1.00 50.00 X X 0 248477 58314 John Turongian end 114 Secretary 1.00 50.00 X X 0 259070 48066 Brother Jeffrey Callander CFA Director 1.00 1.00 X 0 0 0 Mark Frey Ex-Officio Member 1.00 50.00 X 0 1498371 49865 Donna Gauthier Assistant Secretary 1.00 40.00 X 0 74489 15715 Joe Girardi start 614 Chief Financial Officer 1.00 50.00 X 0 0 0 Ken Marx end 114 Chief Financial Officer 1.00 50.00 X 0 190506 42107 Peggy Randell Director of Finance 25.00 25.00 X 0 113714 10286 Scott Peterson Vice President, Human Resources 1.00 50.00 X 0 342755 38484 Daniel Stricker Former Officer 0.00 0.00 X 0 191497 38735 Jim Lewandowski Former Key Employee 0.00 0.00 X 0 722305 15727 0 3771534 333154 0 1 1 0 TouchPoint Support Services PO Box 102289 Atlanta GA 303682289 Dietary/Environmental Services 1405908 SSM Rehab 2455C McMullen Booth Rd Clearwater FL 33759 Therapy Services 1071603 Alexian Brothers Health System 3040 W Salt Creek Ln Arlington Heights IL 60005 Management Services 696768 Alexian Brothers Senior Ministries 12250 Weber Hill Road St Louis MO 63127 Management Services 231123 United Healthcare Insurance Company 22561 Network Place Chicago IL 60673 Employee Insurance 112417 5 25089 548 25637 Medicare & Medicaid 623000 7261544 7261544 Skilled Nursing Svcs 623000 3418894 3418894 10680438 554720 554720 Guest & Employee Meals 722210 9654 9654 Barber/Beauty 900099 8314 8314 Vending Revenue 900099 726 726 595 595 19289 11280084 10680438 0 574009 X 3790481 3470025 320456 94152 85763 8389 421765 380227 41538 276127 250859 25268 9558 9558 5405 5405 1615225 1590400 24825 248949 183852 65097 222141 222141 318746 318746 15277 2776 12501 5107 3050 2057 81084 81084 504755 428777 75978 19656 19656 Purchased Serv-Medical 1167855 1143855 24000 Management Fees 1080257 849134 231123 Medical Supplies 817496 817496 Purchased Serv-Other 54817 54817 660624 627311 33313 11409477 10288172 1121305 0 121384 92216 1880906 1619165 19937 22972 60961 17007 4779615 1209465 3886268 3570150 13034182 14232255 9933 70484 19013571 19624249 835543 646321 39657 43808 875200 690129 X 18131334 18927632 7037 6488 0 18138371 18934120 19013571 19624249 -129393 925142 0 X 0 1 X 1 0 X 1885 15821 4759 5966 25637 54068 11526986 10651288 5765765 11358322 10680438 49982799 11528871 10667109 5770524 11364288 10706075 50036867 0 0 0 50036867 195797 373213 381263 580738 1480411 3011422 195797 373213 381263 580738 1480411 3011422 10247 22044 19289 51580 11724668 11040322 6162034 11967070 12205775 53099869 0.94230 0.97900 0.05670 0.02080 X Schedule A, Part III, Line 12, Explanation of Other Income: Guest Employee Meals Barber/Beauty Vending Revenue All Other Revenue Schedule A, Part IV: For the year ended 6/30/12, the organization filed a short period return due to a change of accounting period. Thus, the amounts in column 2011 of Schedule A reflect the tax year 1/1/2012 - 6/30/2012 activity. Prior balances have been rolled backward. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 702 702 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to trade association of senior centers that is specifically allocable for lobbying. Alexian Brothers Lansdowne Village does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 120000 120000 4014337 1039348 2974989 533324 146443 386881 111954 23674 88280 3570150 Interest in Investments Held by Ascension Health Alliance 14232255 F 14232255 Outstanding Reserve for Insurance Losses 36286 Due to Affiliates - Alexian Brothers Senior Ministries 5940 Due to Affiliates - Alexian Brothers Sherbrooke Village 1582 43808 X Part X, Line 2: From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Alexian Brothers Lansdowne Village: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2014. 1 1 0 0 0 0 0 0 0 Gary Mohn start 114 Director & Secretary 0 199745 0 34606 0 14126 0 28332 0 29982 0 306791 0 14126 John Turongian end 114 Secretary 0 222982 0 20058 0 16030 0 23254 0 24812 0 307136 0 16030 Mark Frey Ex-Officio Member 0 712178 0 693941 0 92252 0 14702 0 35163 0 1548236 0 74752 Ken Marx end 114 Chief Financial Officer 0 175708 0 10027 0 4771 0 14158 0 27949 0 232613 0 0 Scott Peterson Vice President, Human Resources 0 302795 0 39960 0 0 0 14311 0 24173 0 381239 0 0 Daniel Stricker Former Officer 0 155926 0 31199 0 4372 0 10767 0 27968 0 230232 0 4372 Jim Lewandowski Former Key Employee 0 0 0 0 0 722305 0 0 0 15727 0 738032 0 722305 Part I, Line 3 Alexian Brothers Health System, a related organization of Alexian Brothers Lansdowne Village, uses the following methods to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Form 990 of Other Organizations - Compensation Survey or Study - Approval by the Board or Compensation Committee Part I, Line 4a: The following individual listed in Schedule J received the referenced amount of change in control payments in calendar 2013. The payments under a change-of-control arrangement are made in connection with retirement that changed the terms of employment resulting from a change in control of the organization: Jim Lewandowski - $689,832 Part I, Line 4b: Alexian Brothers Health System offers a Supplemental Employee Retirement Plan to all employees who participate in the executive benefits program and whose compensation exceeds the IRS allowable limit for a qualified pension plan. The purpose of the plan is to restore retirement benefits that are restricted because of compensation limits for the executives. No distributions from the supplemental nonqualified retirement plan were made in the current year. Form 990, Part VI, Section A, line 2 John Turongian, Ken Marx, Pierre Smith, Mark Frey, Donna Gauthier, Scott Peterson, Gary Mohn and Joe Girardi have a business relationship due to joint employment by a common health system entity. Form 990, Part VI, Section A, line 6 Alexian Brothers Lansdowne Village has two classes of corporate members, Alexian Brothers Health System (the "National Member") and Alexian Brothers Senior Ministries (the "Area Member"). Form 990, Part VI, Section A, line 7a Alexian Brothers Health System has the authority to appoint and remove Directors and Executive Officers of Alexian Brothers Lansdowne Village. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Alexian Brothers Lansdowne Village's financial information or corporation as a whole are subject to approval by the National Member, Alexian Brothers Health System. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board members are provided the Form 990 and management team members are available to answer any Board Member's questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, Executive Director, or top management official, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee of the Board of Governors of Alexian Brothers Health System reviewed and approved the compensation. In the review of the compensation, the compensation of the CEO, Executive Director, or top management official was compared to compensation of those in positions in other similarly situated organizations that hold the same or a similar title. During the review and approval of the compensation, the documentation of the decision was recorded in the Compensation Committee minutes. The individual was not present when his compensation was decided. In determining compensation of other officers or key employee of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other similarly situated organizations' employees that hold the same or similar title. During the review and approval of the compensation by the Compensation Committee, documentation of the decision was recorded in the minutes. Form 990, Part VI, Section C, line 19 The financial statements of Alexian Brothers Lansdowne Village are available through the National Reporting Municipal Services Information Repository (NRMSIR). Conflict of Interest statements and the governing documents of Alexian Brothers Lansdowne Village are not made available to the public. Form 990, Part IX, line 11g Dietary and Environmental Services: Program service expenses 1,480,492. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,480,492. Beautician Services: Program service expenses 6,005. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,005. Bank Charges: Program service expenses 0. Management and general expenses 8,436. Fundraising expenses 0. Total expenses 8,436. Consulting: Program service expenses 11,881. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,881. Recruiting: Program service expenses 0. Management and general expenses 8,426. Fundraising expenses 0. Total expenses 8,426. Other fees-for-service: Program service expenses 92,022. Management and general expenses 7,963. Fundraising expenses 0. Total expenses 99,985. Form 990, Part XII, Line 2b - Audit Disclosure: The financial statements of Alexian Brothers Lansdowne Village were audited on a consolidated basis. The Audit Committee of the Board of Governors of Alexian Brothers Health System has been delegated the responsibility to oversee the audited financial statements and the selection of the independent accountants that audit the financial statements. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Alexian Brothers Health System 3040 W Salt Creek Lane Arlington Heights IL 60005 363260495 Supports provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Alexian Brothers Bonaventure House 825 Wellington Avenue Chicago IL 60657 363527899 Housing and supportive care services for persons with HIV/AIDS IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Health System Inc Investment Trust 3040 W Salt Creek Lane Arlington Heights IL 60005 363801585 Manages pooled investments of related not-for-profit entities IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Specialty Group 3040 W Salt Creek Lane Arlington Heights IL 60005 800710751 Specialty physician practice group IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers of San Jose Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 941530037 Acute care hospital (sold in 1998) TX Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Brothers Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 431295333 HUD housing MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Village of Milwaukee Inc 9301 N 76th Street Milwaukee WI 53223 391351584 Continuing care retirement community WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Community Services 425 Cumberland Street Suite 110 Chattanooga TN 37404 364344423 Provides comprehensive & coordinated community based services IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Neighbors 250 East 10th Street Chattanooga TN 37402 620646376 Supports the provision of community services for senior citizens TN Section 501(c)(3) Schedule A, Line 7 Alexian Brothers Health System 1 Alexian Village of Tennessee 437 Alexian Way Signal Mountain TN 37377 621136742 Continuing care retirement community TN Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Senior Ministries 3040 W Salt Creek Lane Arlington Heights IL 60005 364484290 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Alexian Elderly Services Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 392039667 Community outreach WI Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Sherbrooke Village 4005 Ripa Avenue St Louis MO 63125 431592502 Skilled nursing facility MO Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Hospital Network 3040 W Salt Creek Lane Arlington Heights IL 60005 363276552 Supports the provision of healthcare services for related corporations IL Section 501(c)(3) Schedule A, Line 11c Alexian Brothers Health System 1 Savelli Properties Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363308965 Owns or leases properties where healthcare services are delivered IL Section 501(c)(2) N/A Alexian Brothers Health System 1 Alexian Brothers Center for Mental Health 3436 N Kennicott Avenue Arlington Heights IL 60004 363045007 Outpatient community mental health services IL Section 501(c)(3) Schedule A, Line 9 Alexian Brothers Health System 1 Alexian Brothers Behavioral Health Hospital 1650 Moon Lake Blvd Hoffman Estates IL 60194 364251848 Behavioral health hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 St Alexius Medical Center 1555 Barrington Road Hoffman Estates IL 60194 364251846 Acute care hospital IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Ambulatory Group 3040 W Salt Creek Lane Arlington Heights IL 60005 364336931 Physician services IL Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Brothers Medical Center 800 Biesterfield Road Elk Grove Village IL 60007 362596381 Acute care hospital TX Section 501(c)(3) Schedule A, Line 3 Alexian Brothers Health System 1 Alexian Rehabilitation Services LLC 935 Beisner Road Elk Grove Village IL 60007 300221481 Rehabilitation hospital IL N/A Illinois NeuroMeg Center LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 870783164 Provision of NeuroMeg services IL N/A Elk Grove MOB Limited Partnership 3040 W Salt Creek Lane Arlington Heights IL 60005 363853289 Medical office building IL N/A Bonaventure Medical Foundation LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 363978153 Manages managed care contracts DE N/A Neurosciences Equipment LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 861115516 Ownership of Gamma Knife IL N/A St Alexius Center for Sleep Health LLC 1300 S Main Street Lombard IL 60148 205876371 Operation of sleep lab IL N/A Thelen Corporation 3040 W Salt Creek Lane Arlington Heights IL 60005 363266316 Owns/leases property; joint venture partner IL N/A C 0 Alexian Brothers Health Providers Association Inc 3040 W Salt Creek Lane Arlington Heights IL 60005 363853286 Messenger model IPA IL N/A C 0 Alexian Brothers Corpus Christi Housing Project LLC 3040 W Salt Creek Lane Arlington Heights IL 60005 943465394 Tax credit financed housing IL N/A C 0 Alexian Village of Elk Grove 3040 W Salt Creek Lane Arlington Heights IL 60005 352211303 Tax credit financed housing IL N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 Alexian Brothers Health System P 777852 FMV Alexian Brothers Senior Ministries P 231123 FMV Alexian Brothers Community Services Q 458887 FMV Alexian Brothers Senior Ministries R 65608 FMV Alexian Brothers Health System S 786022 FMV